Maternal and Fetal Outcomes of Admission for Delivery in Women With Congenital Heart Disease

Hayward, Robert; Foster, Elyse; Tseng, Zian H.

doi:10.1001/jamacardio.2017.0283

Cited by 77 publications

(87 citation statements)

References 40 publications

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“…Increasing pregnancy numbers and rates among women with CHD have also been found in population‐based studies in the United States, and this could be due to several factors . First, the fact that more patients with CHD are known to survive to reproductive age may explain the increase in absolute pregnancy numbers .…”

Section: Discussionmentioning

confidence: 85%

“…Women with CHD had more cesarean deliveries than those without. Several other investigators have also found higher cesarean section rates among women with CHD when compared to pregnant controls . This trend may have further progressed since the cesarean delivery rates within the National Inpatient Sample in the United States from 2000 through 2010 were 40.7% (95% CI [39.7, 41.6]) and 32.3% (95% CI [32.2, 32.3]) among women with and without CHD, respectively .…”

Section: Discussionmentioning

confidence: 92%

“…Several other investigators have also found higher cesarean section rates among women with CHD when compared to pregnant controls. 3,[8][9][10]23 Gestational diabetes, gestational hypertension, and preeclampsia were independently associated cesarean delivery.…”

Section: Discussionmentioning

confidence: 97%

“…To our knowledge, this study was the first to present Canadian population‐based trends of pregnancy rates and delivery outcomes among women of reproductive age with CHD over a period of 13 years. Indeed, several prior studies on pregnancy outcomes in women with CHD have included women already known to be pregnant, precluding estimation of pregnancy rates from the adult CHD population . In addition, Quebec provides universal health care to its resident and more than 99% of women in the province are admitted to hospital for delivery .…”

Section: Discussionmentioning

confidence: 99%

“…Increasing pregnancy numbers and rates among women with CHD have also been found in population-based studies in the United States, and this could be due to several factors. [8][9][10] First, the fact that more patients with CHD are known to survive to reproductive F I G U R E 2 Absolute yearly numbers and rates of pregnancies (A) and deliveries (B) among women with CHD eligible to become pregnant. CHD, congenital heart disease age may explain the increase in absolute pregnancy numbers.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Secular trends in pregnancy rates, delivery outcomes, and related health care utilization among women with congenital heart disease

Bottega

Malhamé

Guo

et al. 2019

Congenital Heart Disease

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Background The number of women with congenital heart disease (CHD) of reproductive age is increasing, yet a description of trends in pregnancy and delivery outcomes in this population is lacking. Objective To assess secular trends in pregnancy rates, delivery outcomes, and related health care utilization in the adult female CHD population in Quebec, Canada. Methods The Quebec CHD database was used to construct a cohort with all women with CHD aged 18‐45 years between 1992 and 2004. Pregnancy and delivery rates were determined yearly and compared to the general population. Secular trends in pregnancy and delivery rates were assessed with linear regression. The cesarean delivery rate in the CHD population was compared to the general population. Predictors of cesarean section were determined with multivariable logistic regression. Cox regression, adjusted for comorbidities, was used to analyze the impact of cesarean sections on 1‐year health care use following delivery. Results About 14 878 women were included. A total of 10 809 pregnancies were identified in 5641 women, of whom 4551 (80%) and 2528 (45%) experienced at least one delivery and/or abortion, respectively. Absolute yearly numbers and rates of pregnancies and deliveries increased during the study period (P < .05). The increment in cesarean section rates was more pronounced among women with CHD than among the general population. Gestational diabetes (OR 1.50, 95% CI [1.13, 1.99]), gestational hypertension (OR 1.81, 95% CI [1.27, 2.57]), and preeclampsia (OR 1.59, 95% CI [1.11, 2.8]) were independent predictors of cesarean delivery. Cesarean sections were associated with postpartum cardiac‐hospitalization within 1 year following delivery (HR = 2.35, 95% CI [1.05, 5.28]). Conclusions Yearly numbers and rates of pregnancies and deliveries in adult females with CHD rose significantly during the study period. Cesarean sections led to increased health care utilization. Further research is required to determine causes of high cesarean section rates in this patient population.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Secular trends in pregnancy rates, delivery outcomes, and related health care utilization among women with congenital heart disease

Bottega

Malhamé

Guo

et al. 2019

Congenital Heart Disease

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Pregnancy in Adult Congenital Heart Disease

Davidson

2017

JAMA Cardiol

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39. Balci A, Sollie-Szarynska KM, van der Bijl AG, et al; ZAHARA-II investigators. Prospective validation and assessment of cardiovascular and offspring risk models for pregnant women with congenital heart disease. Heart. 2014;100(17): 1373-1381. 40. Humphries KH, Rankin JM, Carere RG, Buller CE, Kiely FM, Spinelli JJ. Co-morbidity data in outcomes research: are clinical data derived from administrative databases a reliable alternative to chart review? J Clin Epidemiol. 2000;53(4):343-349. 41. Hameed AB, Lawton ES, McCain CL, et al. Pregnancy-related cardiovascular deaths in California: beyond peripartum cardiomyopathy.

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Comparison of Childbirth Delivery Outcomes and Costs of Care Between Women Experiencing vs Not Experiencing Homelessness

et al. 2021

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IMPORTANCE Women and families constitute the fastest-growing segments of the homeless population. However, there is limited evidence on whether women experiencing homelessness have poorer childbirth delivery outcomes and higher costs of care compared with women not experiencing homelessness. OBJECTIVETo compare childbirth delivery outcomes and costs of care between pregnant women experiencing homelessness vs those not experiencing homelessness. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study included 15 029 pregnant women experiencing homelessness and 308 242 pregnant women not experiencing homelessness who had a delivery hospitalization in 2014. The study used statewide databases that included all hospital admissions in 3 states (ie, Florida, Massachusetts, and New York). Delivery outcomes and delivery-associated costs were compared between pregnant women experiencing homelessness and those not experiencing homelessness cared for at the same hospital (analyzed using the overlap propensity-score weighting method and multivariable regression models with hospital fixed effects).The Benjamini-Hochberg false discovery rate procedure was used to account for multiple comparisons. Data were analyzed from January 2020 through May 2020.EXPOSURE Housing status at delivery hospitalization. MAIN OUTCOMES AND MEASURES Outcome variables included obstetric complications (ie,antepartum hemorrhage, placental abnormalities, premature rupture of the membranes, preterm labor, and postpartum hemorrhage), neonatal complications (ie, fetal distress, fetal growth restriction, and stillbirth), delivery method (ie, cesarean delivery), and delivery-associated costs. RESULTS Among 15 029 pregnant women experiencing homelessness (mean [SD] age, 28.5 [5.9] years) compared with 308 242 pregnant women not experiencing homelessness (mean [SD] age, 29.4 [5.8] years) within the same hospital, those experiencing homelessness were more likely to experience preterm labor (adjusted probability, 10.

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Maternal and Fetal Outcomes of Admission for Delivery in Women With Congenital Heart Disease

Cited by 77 publications

References 40 publications

Secular trends in pregnancy rates, delivery outcomes, and related health care utilization among women with congenital heart disease

Secular trends in pregnancy rates, delivery outcomes, and related health care utilization among women with congenital heart disease

Pregnancy in Adult Congenital Heart Disease

Comparison of Childbirth Delivery Outcomes and Costs of Care Between Women Experiencing vs Not Experiencing Homelessness

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